| NPI | 1669853172 |
|---|---|
| Former Name | CHRISTINA ELIZABETH HEINSSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 23.003372) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 23.003372) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-09-12 |